Angelite Nurses

Tomorrow when we ring in the New Year we’ll also be ringing in the International Year of the Nurse. No kidding. The designation honors the centennial of the death of Florence Nightingale (she died on August 13, 1910). It launches at noon everywhere on January 1 with the Million Nurse Global Caring Field Project, a “global meditation” led by noted nursing theorist Jean Watson, and events will continue throughout the year.

Most of you were probably aware that the United Nations had developed eight Millenium Development Goals (MDGs) that nations should achieve to end poverty and improve the health, education, and quality of life of their peoples. Three of the eight goals are specifically focused on health, but the others all have an impact on health one way or another.

The target date for achieving the goals is 2015, but as countries have implemented programs to achieve these goals they’ve become acutely aware that, without nurses in sufficient supply, they will fall short. For example, how do you reduce the maternal death rate during childbirth if there are few skilled health professionals to provide prenatal care or assist at births? How do you treat TB and HIV when there are no health workers to dispense and monitor drug therapy?

The Florence Nightingale Museum, the Nightingale Initiative for Global Health, and Sigma Theta Tau International are collaborating on the initiative and seek “to recognize the contributions of nurses globally and to engage nurses in the promotion of world health, including the UN MDGs.” This coincides with the work of the World Health Organization (WHO) Office of Nursing and Midwifery over the past few years to increase the visibility and importance of nurses’ roles, both within the WHO and in its member countries. (Here’s my report from the May 2008 WHO meeting.) At the 2010 General Assembly in May, when member nations gather in Geneva, they will consider a resolution reaffirming the crucial role of nurses and midwives in advancing health.

One event to mark the year is a special commemorative service on April 25 at the National Cathedral in Washington, DC. (Details will be forthcoming at this Web site.) Why not plan a road trip with colleagues—attend the service, reflect on the importance of what we do as nurses, and then celebrate with your friends and colleagues.

Nurses work hard every day. When was the last time you took time to think about what you do and the difference it makes to those who are at the receiving end of your knowledge and skill? If you can’t make it to DC, what are you going to do to honor what you and your colleagues do every day?

Lieutenant-Colonel Maureen Gara, who has died aged 93, had an exacting and adventurous career in wartime field hospitals and afterwards was a distinguished military nurse.

On June 14 1944, after the first Normandy landings, Maureen Gara, a Nursing Officer with 79th General Hospital, left in a convoy to set up a large field hospital at Bayeux. On the way to Southampton, people from towns and villages which had been devastated by German bombing cheered her and her colleagues through the streets.

After a sleepless night on the troopship, she clambered down a scramble net into a landing craft, only to find that rough seas prevented the vessel from reaching shore for four hours.

She spent her first night on land in trenches with a 24-hour ration pack for sustenance. There was a battle raging outside Caen, the racket was tremendous, and the ground shook beneath her.

At 10 o'clock the following morning, trucks took her to the site for the hospital. The place was buzzing with troops – Pioneers, Reme, Sappers and Royal Army Service Corps. The marquees were up, generators were humming, boiling water was bubbling in huge cauldrons, kitchens had been assembled and trenches dug.

Crates were unpacked and an enormous Red Cross laid out. By four o'clock in the afternoon, the first casualties were arriving. Four hundred came in that night.

Mary Anne Gara, always known as Maureen, was the eldest of seven children in a family of subsistence farmers. She was born in rural Ireland, near Carrick, County Donegal, on January 18 1916. Her mother died suddenly and Maureen's aunt took over care of the family, leaving the girl free to pursue her ambition to become a nurse.

Maureen went to a convent school and won a scholarship which enabled her to continue studying beyond the age of 14. After qualifying at a training school in Manchester, she volunteered to join the reserve of Queen Alexandra's Imperial Military Nursing Service (QAIMNS) and, in December 1943, was sent to the 79th General Hospital at Watford.

It was a mobilisation unit housed in the dreary, dark buildings of a St Agatha's orphanage. Gara was met by a woman in full battledress, boots and gaiters who trained her and the other nurses in military medical procedures, tentage and drill. The first task was to make up 600 bed rolls in readiness for deploying as a field hospital at the front.

In April 1944, she moved to Peebles Hydro, Scotland, where she trained in chemical warfare and mountaineering. In May, the hospital moved to East Anglia with a large concentration of troops ready for D-Day. In her spare time, she and other nurses were sent out on to the lawns to sew a huge red cross made out of hessian.

The surgeons in the hospital in Normandy, she said afterwards, were the best that Britain could provide. Casualties had to be kept moving so that there were always trestle tables available. There was an airstrip nearby and an efficient evacuation system was organised.

Penicillin was regarded as the new miracle drug but in emergencies there was not time to test patients for allergic reactions. On one occasion, a soldier that she was treating had a violent reaction to the drug and reached for a scalpel to kill himself. Only with great difficulty did she prevent him doing so.

The alarm was raised one night when movement was spotted in bushes near the sleeping quarters. The hunt for a suspected prowling German soldier was called off when the real culprit, a stray cow, poked its head into Gara's tent.

While she was in Normandy, she used to watch the Luftwaffe bombers flying overhead on bombing raids. They deliberately avoided bombing the hospital area and one particular aircraft with distinctive markings always dipped its wing as it passed over the hospital. Some years later, at an event in Germany, Maureen Gara mentioned this. One of the pilots present said: "Madam, that was my plane."

In September, Gara moved with the hospital to Holland for the battles of Arnhem and the Rhine crossing. On the way, she stopped in Brussels for her first proper bath since leaving England.

After the war, she applied to join the Regular QAIMNS, later designated the Queen Alexandra's Royal Army Nursing Corps (QARANC), and was posted to India. She subsequently served in the Middle East, in Singapore and at the Commonwealth Hospital, Terendak, Melaka, Malaysia, where she was deputy matron.

In 1967, she was promoted lieutenant-colonel and posted to the QARANC training centre as chief instructor. Two years later, she was awarded the Royal Red Cross for excellence in military nursing and she moved to the Queen Alexandra Hospital, Millbank, as matron. She retired in 1971.

Settled in the Aldershot area, she became involved with the Normandy Veterans and Queen Alexandra Associations and served as a trustee and subsequently chairman of the latter for a total of 11 years. She never lost her love of her native Ireland and its traditional music – her father and two of her brothers played the fiddle. She also enjoyed travelling and went on several world cruises.

In 2004, to commemorate the 60th anniversary of D-Day, a stamp of St Vincent and the Grenadines was printed in her honour.

Maureen Gara died on October 19. She never married.

Registered nurse Shirley Cooley, right, helps nursing student Anna Hung-Chan give a vaccine to a newborn at Mount Carmel East hospital on the Far East Side.

The bad economy might make it seem as if there's no shortage of nurses in central Ohio, but experts say the situation is temporary.

"We are seeing nurses who might have been considering leaving the profession, ready to retire, and they're not doing that," said Janice Lanier, deputy executive officer of the Ohio Nurses Association.A recent report from the Health Policy Institute of Ohio projects that Ohio is one of three states, along with Texas and California, that will have the greatest need for nurses in a decade.

Researchers expect Ohio to be short 32,000 nurses by 2020.

Besides an aging population with more chronic medical conditions, impending health reform could mean that 1.3 million uninsured Ohioans will have insurance.

"They can start coming into (medical) practices, and what's that going to do to the demand on getting in?" said William Hayes, president of the policy institute. "We have to be ready for the need."

Advanced-practice nurses, including nurse practitioners, could provide newly insured people with primary medical care.

"Just because we don't have the shortage hitting us over the head every day now, we should not take it off the policy plate," Lanier said.

There are more than 2.4 million registered nurses in the United States, making it the largest health profession. The average age of an Ohio nurse is 47, and the median age of a nursing faculty member is 51.

Nursing schools still have waiting lists, but that's because there are not enough faculty members to train future nurses, experts say.

Plus, some local hospitals aren't hiring nurses the way they did a few years ago because of the economy.

Sarah Strohminger, a junior at MedCentral College of Nursing in Mansfield, said she knows of nursing graduates who could not find work in Mansfield or Columbus.

Strohminger, president of the Ohio Nursing Students' Association, said she plans to work as a patient care assistant at MedCentral to get her foot in the door at the hospital.

Ann Schiele, president of the Mount Carmel College of Nursing, said all 160 nurses who graduated from there in May have found jobs.

"It may not have been their first position of choice … but by August every student that I was aware of had a position," she said.

Ohio State University Medical Center, which hasn't made the cutbacks that other local hospital systems have, continues to hire nurses, including at least 140 new graduates every year.

"There is not a shortage in central Ohio of new grads, but there will always be a shortage of specialized nurses," said Karen Bryer, director of medical-center recruitment at Ohio State.

Specialized nurses include those trained to work in intensive-care and neonatal units, and advanced-practice nurses such as nurse anesthetists.

Schiele expects the local hiring lull to end in about three years, and then there will be an immediate need for nurses. By then, aging faculty members will be retiring.

"It's all very important that we get the funding to educate the faculty in the master's and doctoral programs," she said.

That's where state officials could come in. The state could help pay off student loans or provide grants, tuition assistance for nurses who want to teach, or a refundable tax credit for nursing faculty members.

There have been some state policy moves to address the shortage.

These include changing the Nurse Education Assistance Loan Program in the state's budget bill this year to forgive student loans of nursing master's students who teach nursing at an Ohio school, Allison Kolodziej, Gov. Ted Strickland's spokeswoman wrote in an e-mail.

Lanier said policymakers shouldn't wait until hospitals complain that there aren't enough nurses.

"There's nothing worse from a patient-safety perspective than having an entire floor staffed with brand-new nurses," Lanier said. "You need to have that mix."

shoholik@dispatch.com